Health workers in the region have given a qualified welcome to the Chancellor's extra billions.

While the commitment to pour extra funds into the NHS was well received, concern was expressed about how the money would be used.

The strongest reservations came from Dr Bill Ryder, who chairs the British Medical Association's consultants and specialists committee in the North-East.

"It all sounds very nice, but there are things that worry me and which suggest to me that Mr Brown is speaking with a forked tongue," said Dr Ryder, who is a locum anaesthetist at the Queen Elizabeth Hospital, in Gateshead.

"If all of this money is to produce figures which can be spun, then it is money that is wasted or misused.

"If it is used to provide more quality, then it is a good thing," he said.

Dr Ryder believes the emphasis on increasing the number of patients treated at the expense of quality will push up the already enormous cost of compensating the victims of medical negligence.

The consultant also fears that the recently-founded primary care trusts, and the new audit quangos being set up to monitor NHS spending, will absorb much of the extra money.

Margaret Toase, Unison steward at South Tees Hospitals NHS Trust, in Middlesbrough, said she was "very, very suspicous" about how the extra money would be spent.

One of the priority areas for resources should be to improve pay for health workers. "If some of this money could be spent tackling low pay, it would be the answer to the prayers of all NHS staff - but it probably won't," she said.

Medical secretary Pat Bullock, who works at Darlington Memorial Hospital, said the extra cash had to be invested in expanding the infrastructure of the NHS. Instead of "firefighting" and using the cash to send patients to private hospitals, it should be invested in NHS hospitals.

Mrs Bullock, whose colleagues were on the brink of taking strike action over pay until the South Durham trust agreed to pay higher rates, warned that something must be done to address the problem of low pay in the NHS.

"Ancillary and catering staff play their part, but they get barely more than the minimum wage," she said.

While he welcomed a much larger increase than expected, Peter Johnson, of South Tees Community Health Council, is worried about how the cash will be spent.

"If that money is as closely targeted as previous money, we may be facing a major disaster," he said.

"What we need is for the money to go into increasing general capacity. It must go on bread-and-butter stuff. If it isn't, we could make a major mistake."

Ken Jarrold, chief executive of the new County Durham and Tees Valley Strategic Health Authority, said the announcement was "very good news for the NHS".

The Chancellor's announcement of extra cash came after the publication of the Wanless Report, which called for massive increase in Government investment to bring British standards of healthcare up to European levels.